Abstract

OBJECTIVE: To estimate the frequency of eosinophilic-intermediate metaplasia of the cervix and to identify the histological characteristics.

MATERIALS AND METHOD: A prospective, and observational study was made. We reviewed cervical biopsies from March 2006 to December 31, 2016, and in a second stage biopsies from January to June 2022. The criteria for making the diagnosis of eosinophilic metaplasia (EM) were taught by one of the authors (JJCV) to the pathologists, who in routine practice issued this diagnosis 5,000 biopsies were reviewed between March 2006 and December 31, 2016, and 122 between January and June 2022.

RESULTS: A total of of 5000 biopsies were reviewed; 204/5000 cases (4.4%) and 31/122 cases (25.4%) were detected with EM.

CONCLUSIONS: The importance of recognizing it lies in the fact that most of these cases are diagnosed as low-grade intraepithelial lesions (LGSIL), although in accordance with the recommendations of the American Association of Colposcopy and Cervical Pathology (ASCCP) and the American Association of Cervical Cancer (ACS), as well as Mexican NOM 041 for Detection and Prevention of Cervical and Breast Cancer must be observed and not receive treatment, most of the cases receive treatment and some in an excessive way.

KEYWORDS: Uterine cervix; Uterine cervix metaplasia; Eosinophilic metaplasia; Low-grade intraepithelial lesions; Uterine cervical dysplasia; Cervical cancer.

Resumen

OBJETIVO: Estimar la frecuencia de metaplasia eosinofílica-intermedia de cuello uterino e identificar las características histológicas.

MATERIALES Y MÉTODOS: Estudio prospectivo y observacional, llevado a cabo a partir de la revisión de expedientes de biopsias de cuello uterino, de marzo de 2006 a diciembre de 2016, y en una segunda etapa de enero a junio de 2022. Los criterios para establecer el diagnóstico de metaplasia eosinofílica (ME) fueron enseñados por uno de los autores (JJCV) a los patólogos, quien en la práctica habitual emitió el diagnóstico.

RESULTADOS: Se revisaron 5000 biopsias. Se detectaron 204 de 5000 casos (4.4%) y 31 de 122 casos (25.4%) con metaplasia eosinofílica-intermedia.

CONCLUSIONES: La importancia del reconocimiento de metaplasia eosinofílica-intermedia radica en que la mayoría de los casos se diagnostican como lesiones intraepiteliales de bajo grado (LGSIL), aunque de acuerdo con las recomendaciones de la Asociación Americana de Colposcopia y Patología Cervical (ASCCP) y la Asociación Americana de Cáncer de Cuello Uterino (ACS), así como la NOM 041 Mexicana para la Detección y Prevención del Cáncer de Cuello Uterino y de Mama, deben mantenerse en vigilancia y no recibir tratamiento; no obstante, la mayoría lo recibe, incluso de manera excesiva.

PALABRAS CLAVE: Cuello uterino; metaplasia del cuello uterino; metaplasia eosinofílica; lesión intraepitelial de bajo grado; displasia del cuello uterino; cáncer de cuello uterino.